Dental, vision clinics adjust to new 'normal'

WORLAND — Vision and dental clinics have adjusted to a new normal with the novel coronavirus 2019 (COVID-19) and this new normal will likely translate into another new normal once businesses are able to return back to regular practices.

The Centers for Disease Control and Prevention issued guidelines for vision and dental clinics in mid to late March. Dr. Kirby Treat of Clear Image Vision said their biggest changes in patient protocol came on March 23.

Treat said they are primarily seeing patients for emergency or urgent care, but added, “we do have some routine exams we’re seeing still. We’re making sure the patients are not at risk, have not been sick recently, haven’t been traveling. They have spaced out the schedule so that there is only one to two patients in the office at a time. They also have shortened their hours, 8:30 a.m. to 5 p.m. Monday through Thursday, 8:30 a.m. to noon on Friday.

“So far this seems to be working well. For routine patients is primarily those who have had a big change and are really struggling. Patients have been understanding and cooperative,” Treat said.

He said they wear masks when in contact with patients and the cleaning and sterilization is something they have been doing and are continuing to do.

“We’re disinfecting all day long, but now we are doing it more often,” he said.

“We’ll have to adapt to a new normal,” Treat said.

As for supplies, he said they have what they need with local businesses assisting in helping provide sanitizer.

Treat said the patient load has dropped from 30 to 50 a day to about 12 to 15 a day now.

“If anyone has any concern about their eyes we can work with them over the phone. Definitely call if you have concern about any part of their eye. Don’t let things go if you are concerned,” Treat said.

“I’m optimistic we’re going to be able to move forward here real soon,” Treat said.

WORLAND VISION

Dr. Carl Cottrell of Worland Vision Clinic welcomed the telephone interview, noting “I miss people.”

He said they are accepting patients only for emergency and urgent care at this time. What is urgent care? “That’s a grey area,” he said. “If I broke my glasses, I can’t see, so I would think that would be urgent; so we’re doing this on a case-by-case basis.”

He said they are doing curbside dispensing for people just picking up items or drop off items at the clinic.

When a patient comes in they will find a “very sterilized and cleaned office and exam room. He said patients are welcome to wear masks if they desire.

“If I’m closer than six feet I have a mask and gloves on,” he said. “We are taking precautions.”

For emergency or urgent care patients, he provides a controlled environment with only one patient allowed in the building at a time. Everything is cleaned in between patients, he said.

He said the Centers for Disease Control and Prevention recommended in late March that vision clinics do not see patients for routine eye care during the pandemic.

“It was more of a recommendation to be a solution to the problem rather than be part of the problem,” Cottrell said.

Having the office closed to most of his patients has been hard. “I see patients, that’s what I like to do. When you are asked not to, it’s kind of hard,” Cottrell said.

He said the change, obviously, means a decrease in the number of patients he sees on a daily basis. “You worry about it for sure. I just need to start seeing patients some time,” Cottrell said.

With the White House offering a phase-in approach to opening up businesses again, and Wyoming Governor Mark Gordon announcing that he is developing a plan for that transition phase as well. “Our transition into a new phase must be health data-driven, not date driven,” Governor Gordon continued. “If the people of Wyoming continue to do the right thing and we see the improvements we need to see, we will continue our transition to a stabilized economy. We need our economy back, but we must avoid a resurgence of this virus,” he said.

Cottrell believes when they are allowed to open up fully to regular patients it will be a “wean-in type of situation.”

He said, “We’ve kind of learned our lesson as a country that we better pay attention to sterilization. We’re going to continue to be precautionary-type of office.”

The doors are locked at Worland Vision Clinic with patients asked to call and leave a message.

During this time, Cottrell has a message for his patients, “We want people to be able to function. Contact lenses, glasses, please call in if we need to do something. We’re not going to sit back and have kids not be able see computers. We’re here. We’re mindful of how long this is going. Being able to see is a priority.”

He added, “Keep washing your hands. Your eyes can be affected with bacterial infection and viral. We’re not immune to that even though it’s the coronavirus we’re worried about right now, there are other things out there.”

As for supplies, he said they are getting what they need but “things are slower. What used to take a few days, now takes a week.”

“We’re going to be OK. We need to stay strong as a community and be mindful of some of the offices that are down, currently. I can’t wait to take my family out to eat and sit down at a restaurant somewhere. We need to be mindful of that and help each other through this. It’s great to be in Worland, Wyoming, all on the same team.”

JEFFRIES DENTAL

Kammie Jeffries of Jeffries Dental said they are staying open Monday through Thursday 8 a.m. to noon with an office manager answering the phone.

“We are seeing emergencies and tooth aches for the most part,” she said.

Jeffries said she hopes they are able to open up to other patients soon. “It’s hard to let people go this long,” she said.

She said she has found that many patients didn’t bother to call when they were having toothaches or other dental issues the first two weeks and now they are calling with the unknown of how long the pandemic will last.

She said toothache pain is usually caused by an infection which can cause inflammation and that can affect overall body health, so people should not wait to call.

People who are coming in for an appointment seem to want to visit longer, just to have that social interaction that is not available with the social guidelines.

She said they schedule an additional 15 minutes between patients to make sure there is no crossover.

“We are cleaning like we always have because we always try to keep the office disinfected and the instruments sterile,” she said. “When a patient comes in we take their temperature and ask them how they are feeling.”

For the future, Jeffries said, “I’m not sure what the landscape will be if people are going to want preventive work like cleaning.”

They also wear masks when working on patients, something that has not changed. They also wear gloves and change those when they leave a room.

They are currently not wearing gowns at this time but that may be a recommendation coming down.

She said Jeffries Dental in Worland is seeing about one-fifth of the patients they normally see.

For people at home, she said it is important to get your regular cleaning when “all this is over. I don’t think you need to worry about getting anything in a dentist office. We are one of the cleaner, more disinfected areas and always have been.”

Jeffries is reminded when AIDS first came out dentists rarely wore gloves and now it is standard practice, so some changes from COVID-19 may be expected.

“I don’t want to get to the point where we have to wear gowns and face shields [with every patient]. It takes away from patient contact. We’re in a unique area where people don’t just look at you as a professional … they want to have a relationship and every time you add more barriers it takes away from that relationship.”

NELSON & PAGE

Dr. Jimmy Nelson of Nelson & Page Dental said they are open to patients for emergency and urgent care, defining that as those with pain, potential pain or having something broken (tooth, crown or denture).

He said when patients call in they make sure the patient is healthy, has not traveled out of the area the past two weeks and is willing to come in to the office.

“We ask them to wait in the car, give us a call when they arrive and we escort them directly to the [exam] chair.”

Typically dentists and dental hygienists wear masks and gloves, but he said the American Dental Association is also recommending for dental surgeries to use a face shield and disposable gowns. If the additional personal protective equipment is unavailable they are advised to “be careful.”

He said their patients have been extremely understanding through the changes.

The Nelson & Page front office staff is at the office Monday through Thursday during regular business hours with a dentist at the office in the morning.

He said with each exam room larger than six feet apart and they work to make sure there is no more than 10 people in the office at any one time.

Regarding patients, he said they are seeing about 15% of what they normally see.

As for the future, Nelson said “We will probably limit the number of people in the waiting room and limit the number of things offered in the waiting room that people handle including magazines and toys.”

For those waiting for a routine check-up, Nelson reminds people “Most of the dental work we treat is preventable by cutting back on sweets, remember to brush twice a day and floss once a day.”